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- 2017
LDL-C和non-HDL-C对家族性高三酰甘油血症和家族性混合型高脂血症的鉴别诊断价值的比较
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Abstract:
摘要：目的 比较低密度脂蛋白胆固醇(LDL-C)和非高密度脂蛋白胆固醇(non-HDL-C)在家族性高三酰甘油血症(FHTG)和家族性混合型高脂血症(FCHL)鉴别诊断中的应用价值。方法 选取9个FHTG家系共94人、24个FCHL家系共94人，根据血脂异常情况将2个家系再分为受累组和未受累组；另设10个对照家系(共57人)。比较各家系血清三酰甘油(TAG)、总胆固醇(TC)、HDL-C、LDL-C、non-HDL-C等血脂指标水平；FHTG家系和FCHL家系按TAG水平分层后，分析non-HDL-C和LDL-C的相关性；最后用受试者工作特征曲线(ROC曲线)分析比较non-HDL-C和LDL-C用于FHTG家系和FCHL家系鉴别诊断的cut-off值。结果 FHTG家系受累组TAG、TC、non-HDL-C水平均高于未受累组和对照组(P<0.01或P<0.05)；FCHL家系受累组TAG、TC、HDL-C、LDL-C、non-HDL-C水平均高于未受累组和对照组(P<0.01或P<0.05)；FHTG家系受累组TAG水平显著高于FCHL家系受累组(P<0.01)，而TC、HDL-C、LDL-C、non-HDL-C水平低于FCHL家系(P<0.01或P<0.05)。FHTG家系和FCHL家系内non-HDL-C和LDL-C均呈正相关，但随TAG水平升高其相关性均呈下降趋势；LDL-C和non-HDL-C用于FHTG家系和FCHL家系鉴别诊断的最佳cut-off值分别为3.575、4.525mmol/L。结论 除常规血脂指标外，non-HDL-C可能是鉴别诊断FHTG家系和FCHL家系的新指标；其鉴别诊断价值可能优于LDL-C。
ABSTRACT: Objective To evaluate the value of low-density lipoprotein-cholesterol (LDL-C) and non-high-density lipoprotein-cholesterol (non-HDL-C) in differential diagnosis of familial hypertriglyceridemia (FHTG) and familial combined hyperlipidemia (FCHL). Methods We recruited 9 FHTG pedigrees (94 subjects) and 24 FCHL pedigrees (94 subjects) and then divided them into affected groups and non-affected groups according to lipid abnormality. Another 10 normal control pedigrees (57 subjects) served as controls. We compared the routine lipid levels such as triglyceride (TAG), total cholesterol (TC), HDL-C and LDL-C and non-HDL-C between the groups. After stratification based on TAG level, we observed the relationship between LDL-C and non-HDL-C. Last we confirmed and analyzed the cut-off value of differential diagnosis between FHTG and FCHL with receiver operating characteristic (ROC) curve. Results The levels of TAG, TC, and non-HDL-C were significantly higher in the affected group of FHTG than in the non-affected group of FHTG and the normal group (P<0.01 or P<0.05). The levels of TAG, TC, HDL-C, LDL-C and non-HDL-C were significantly higher in the affected group of FCHL than in the non-affected group of FCHL and the normal group (P<0.01 or P<0.05). The levels of TAG were significantly higher (P<0.01) while TC, HDL-C, LDL-C and non-HDL-C levels were significantly lower (P<0.01 or P<0.05) in the affected group of FHTG than in the affected group of FCHL. The association between LDL-C and non-HDL-C was positive both in FHTG and FCHL, but the relationship became weaker as TAG level increased. The cut-off value of LDL-C and non-HDL-C was 3.575mmol/L and 4.525mmol/L, respectively. Conclusion In addition to the routinely used lipid indexes, non-HDL-C may be a new index for differential diagnosis of
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